Friday, December 16, 2011

http://www.medicare-plans.net/medicare-plans-non-renewing-in-2012/

Thursday, September 15, 2011

http://www.medicare-plans.net/new-special-enrollment-period-for-medicare-in-2012/
http://www.medicare-plans.net/medicare-beneficiaries-lose-enrollment-period-in-2011/
http://www.medicare-plans.net/medicare-plans-leaving-in-2011/
http://www.medicare-plans.net/get-your-250-rebate-from-medicare/
http://www.medicare-plans.net/2011-medicare-advantage-plans-now-available/
http://www.medicare-plans.net/medicare-advantage-pitfalls-and-recommendations/
http://www.medicare-plans.net/thank-you-medicare-advantage-for-leaving-town/
http://www.medicare-plans.net/medicare-advantage-or-medicare-supplement-in-2011/
http://www.medicare-plans.net/humana-medicare-advantage-plans-have-some-unpleasant-surprises-in-2011/
http://www.medicare-plans.net/medicare-changes-for-2011/
http://www.medicare-plans.net/aarp-united-healthcare-medicare-advantage-plans-2011/
http://www.medicare-plans.net/medicare-advantage-hmo-vs-ppo/
http://www.medicare-plans.net/blue-cross-blue-shield-medicare-advantage-for-2011/
http://www.medicare-plans.net/medicare-and-medicaid/
http://www.medicare-plans.net/enrollment-period-ends-for-medicare-beneficiaries-whose-plan-left-the-area/
http://www.medicare-plans.net/what-is-the-medicare-part-d-donut-hole/
http://www.medicare-plans.net/how-to-avoid-the-part-d-medicare-donut-hole/
http://www.medicare-plans.net/types-of-medicare-insurance/
http://www.medicare-plans.net/choosing-between-medicare-advantage-plans-for-2012/
http://www.medicare-plans.net/budget-deal-spares-medicare-for-now/
http://www.medicare-plans.net/new-medicare-enrollment-period-for-2012-approaches/
http://www.medicare-plans.net/you-may-qualify-for-extra-help-paying-for-medicare-prescription-drug-costs-in-2011/
http://www.medicare-plans.net/medicare-insurance-supplements-in-2012/
http://www.medicare-plans.net/medicare-supplement-plan-a/
http://www.medicare-plans.net/no-premium-increase-for-medicare-pdp-in-2012/
http://www.medicare-plans.net/medicare-supplement-plan-b/
http://www.medicare-plans.net/medicare-supplement-plan-c/
http://www.medicare-plans.net/medicare-supplement-plan-g/
http://www.medicare-plans.net/medicare-supplement-plan-d/
http://www.medicare-plans.net/medicare-supplement-plan-k-plan-l-and-plan-m/
http://www.medicare-plans.net/medicare-supplement-plan-n/
http://www.medicare-plans.net/medicare-supplement-plan-f/
http://www.medicare-plans.net/medicare-excess-charges/
http://www.medicare-plans.net/how-to-apply-for-medicare/
http://www.medicare-plans.net/when-to-apply-for-medicare/
http://www.medicare-plans.net/what-is-medicare-coverage/
http://www.medicare-plans.net/united-healthcare-medicare-advantage-changes-brand-in-2012/
http://www.medicare-plans.net/medicare-advantage-enrollment-dates-for-2012/
http://www.medicare-plans.net/medicare-part-d-2012-preview/
http://www.medicare-plans.net/medicare-advantage-2011/

Friday, September 2, 2011

Do Medicare Advantage Plans Make Sense in 2012


Probably one of the hardest things you have to do as a Medicare beneficiary is determine if it makes sense for you to be in a Medicare Advantage program or not.  When you have Medicare Part A and Part B you really have one decision to make.  You need to decide whether you should have a Medicare supplement and a Part D drug plan along with your Medicare Part A and Part B, or do you go the route of Medicare Advantage otherwise known as Medicare Part C.

You can't have both so a decision needs to be made on which direction to go.  They actually work opposite of each other so there is not much similarity between them at all.  For example:

  1. Medicare Advantage has little or NO premium 
  2. Medicare Supplements have a substantial monthly premium
  3. Medicare Advantage uses a network of doctors and hospitals
  4. Medicare Supplements work anywhere Medicare is accepted
  5. Medicare Advantage costs every time you use it
  6. Medicare Supplement Plan F has no cost to use it
  7. Medicare Advantage typically includes Medicare Part D drug covergae
  8. Medicare Supplements no longer include Medicare Part D drug coverage
To help you decide ask yourself these questions:
  1. How often do I go to the doctor or hospital?
  2. Do I see a bunch of doctors/specialist or am I attached to my current doctor
  3. Do I want to save money with the risk of potentially saving more
If you answered "Once or Twice a Year" to number 1 then Medicare Advantage could be right for you.  If you answered "No" to number two then Medicare Advantage could be right for you, and finally, if you answered "Yes" to number three then Medicare Advantage could be right for you.  Just make sure you check the network for the Medicare Advantage Plan in 2011 that you are considering and make sure your doctor is accepting it.

Some of the more popular Medicare Advantage plans are Humana, BCBS, Wellcare, AARP, and Health Springs.


Monday, July 25, 2011

What is the Medicare Part D Coverage Gap

The Part D Coverage Gap used to be known as the "Doughnut Hole".  The Coverage Gap relates to a gap in the Medicare Part D coverage.  The gap in coverage affects many seniors that take several name brand drugs or many drugs that carry a high price tag.  Seniors with a Medicare drug plan start the year with coverage for their drugs.  If their drug costs reach a certain point they go into the gap where they have lower coverage for their drugs.  After they have spent a large amount of money they come out of the gap and have what is considered catastrophic coverage. 

The numbers for the gap for 2011 are as follows:  Coverage Gap begins at $2,840 and goes until $4,550
During the gap you must pay 50% of name brand drugs and 93% of generic drugs.  You pay around $2 - $6 for drugs once you are in catastrophic coverage.

NOTE:  The plan costs and your costs for the drugs count toward getting you into the gap.  Only your costs for drugs count toward getting you out of the gap!  This makes it harder for seniors to get out of the coverage gap.  There are several things that I recommend to my clients to help them avoid the Coverage Gap, or lower their costs during the coverage gap.  Please see my article on Avoiding the Medicare Part D Coverage Gap for these great tips!

Wednesday, July 20, 2011

What is Medicare Part D

Of the four parts of Medicare, Part D is then newest and the most complex.  I still get asked what is Medicare Part D which means that the government is failing to do a proper job of educating seniors on this very important and vital part of Medicare.  Medicare Part D covers prescription drugs that are typically filled at your local pharmacy or filled through mail order.  The typical Part D drug plan consists of four Tiers generally referred to as Tier 1, Tier 2, Tier 3, and Tier 4.  Tier 1 is for generic drugs, Tier 2 is for Preferred Brand, Tier 3 is for Non-Preferred Brand, and Tier 4 is for Specialty drugs.

Medicare Part D is administered through private insurance companies such as Humana, Wellcare, BCBS, AARP United Healthcare, and many others.  They are county specific, and their costs vary greatly from plan to plan and from region to region.  Also take note of whether or not the plan has a deductible.  Deductibles are common in Part D plans.  The important considerations when determining the best drug plan for you is to consider the costs, formulary, and your pharmacy choice.  A formulary is a list of drugs that is covered by the plan as well as their level of coverage or Tier.

NOTE:  Not all formularies are created equal!  Many times you will find your drug on one formulary and not on another.  Also, it is not unusual to find your drug on different Tiers on different formularies.

Finally, to complicate things even more they throw in the coverage gap, enrollment periods, and a penalty.  Please see my article on the Medicare Part D coverage gap, enrollment periods, and penalty for more detail on those subjects.

In summary, you will pay a monthly premium for Part D of Medicare which will be determined by which plan you select.  You need to check the plan's formulary against the drugs you are taking to determine whether your drug is covered and how well it is covered.   A great resource to accomplish this is online at www.medicare.gov

Tuesday, March 1, 2011

Enrollment Period ends for beneficiaries whose plan left the area

February 28, 2011 marked the end of the Enrollment Period granted by CMS for those Medicare Beneficiaries who lost their coverage due to their plan leaving the area.  On February 7 CMS sent out a notice saying they were extending the Special Enrollment Period (SEP) for individuals affected by Medicare Advantage (MA) and Part D plan (PDP) non-renewals (NRs) or service area reductions (SARs) to February 28, 2011 from the original end date of January 31, 2011.

Hopefully, everyone was able to make the necessary changes to their Medicare coverage as only the standard Special Enrollment Periods (SEPs) remain for those needing to make a change to their Medicare Advantage Prescription Drug Plans (MAPDs) and Prescription Drug Plans (PDPs)